Surgical device for removing tissue cells from a biological structure

ABSTRACT

The invention allows an increase in scope of application of a surgical device wherein the operational handpiece is embodied in the form of two parts, one of which includes a handpiece with an injection cannula and the other being a complementary part. The complementary part includes a stabilization handle and can be placed onto the injection cannula in addition to being able to be fixed to the handpiece of the operational handpiece.

The invention relates to a device according to the preamble of claim 1.Such devices and instruments are used in surgical clinical settings tosuction off fatty tissue for health and cosmetic reasons. Such devicesand instruments are also used for removing vital tissue cells, forexample from the liver, for the purpose of reproducing these tissuecells through cell division and then inserting the tissue cells in thesame or in a different biological structure.

A number of methods and devices are known that can achieve this goal.

For example, DE 299 14 230 U1 describes a cannula for suctioning offfatty tissue, with the cannula formed as a tube that has one closed endand an other open end that is connected by an adapter to a suctiondevice. The tube includes several suction openings distributed along theperiphery, with the size of the openings adapted to the size of thefatty tissue cells.

The cannula is pierced into the corresponding tissue layers and iscontinuously moved back and forth during the procedure. Through theforce generated by the vacuum and with support of the mechanical forceof the moving cannula, tissue cells are destructively torn away and thensuctioned off. This method is very stressful for the patient and istherefore only rarely used in practice.

It is known to reduce the stress by injecting, in a separate processstep before the surgical procedure, a process fluid into the affectedtissue to dissolve the tissue cells, which can then be more effectivelyand more easily suctioned off. The injected process fluid together withthe dissolved tissue cells are suctioned off through the suction tube.

DE 200 09 786 U1 describes a device for suctioning off fatty tissue,which functionally combines the two aforedescribed process steps, i.e.,injecting the tissue-dissolving process fluid and suctioning off thedissolved tissue cells. For this purpose, an interior injection line forthe tissue-dissolving process fluid is arranged in the suction cannula,with the exit opening of the injection line disposed on the distal endof the suction cannula and connected to a process fluid pump. In thisway, process fluid is injected continuously and suctioned off togetherwith the fatty tissue cells. This makes the process more continuous andshortens the duration of the surgical procedure.

Disadvantageously, however, the aforementioned technical solutions havein common that they destroy not only the fatty tissue cells, but alsoadjacent tissue cells, such as blood cells. This can harm the human bodyand complicate and prolong the healing process. These technicalsolutions are therefore not suitable for removing healthy tissue cellsfor further use.

DE 100 33 278 A1 describes a surgical device for removing tissue cellsfrom a biological structure that obviates this disadvantage. This deviceincludes a water jet unit with a pressure generator and an injectioncannula emitting a separation water jet under pressure, and a suctiondevice that includes a suction pump and a suction tube with the suctionopenings distributed along the periphery, through which the separatedtissue cells are discharged together with the used water. The injectioncannula for the emitted water jet is arranged in the interior of thesuction tube, with both the cannula and the suction tube combined in ahand piece that can be interchanged via a screw-in adapter.

The exit opening of the injection cannula has a cross-section and theexiting water jet a pressure suitable to cause the water jet to exert apeeling effect.

The water jet is able to cut through or separate tissue parts. However,the tissue cells are not destroyed, because due to the curved surfaceand the pliability of the tissue cells, the water jet does notexperience any resistance and is therefore not deflected in itseffective direction. As a result, the water jet finds its way betweenthe tissue cells in an intelligent manner, until it meets resistanceessential for developing a separation force, thereby urging the adjacenttissue cells apart and separating them, without destroying them. Becausethe selection is gentle, there is no need to inject a process fluid fordissolving the tissue cells, as was required in the prior art.

The relatively large number of applications and the large number ofimplementations of such hand piece, due to the different requireddiameters, and the desired high utilization rate for the entireapparatus make it necessary to have a large number of hand piecesavailable with different lengths, different diameters of the suctiontube, and different suction openings in the suction tube. This largenumber of tools makes the entire unit unduly expensive.

Moreover, many situations require application of an anesthetic beforethe surgical procedure, which necessitates special injectioninstruments. This further increases the cost of the surgical procedureand the conversion time from the injection unit to the tissue removalunit, and vice versa.

It is therefore an object of the invention to develop a device of theaforedescribed type for removal of tissue cells, which can be useduniversally for anesthesia and for tissue removal and which has a simpledesign and is easy to operate.

This object is solved by the characterizing features of claim 1. Furtherembodiments are recited in the dependent claims 2 to 5. The novelsurgical device eliminates the aforementioned disadvantages of the stateof the art.

The particular advantage of the novel surgical device is its universalapplicability. The basic configuration, which includes the handle andthe injection cannula, can be provided with a variety of complementaryparts and hence be adapted to the respective specific application. Thecomplementary parts can be easily and quickly exchanged, which savessignificantly time in the operating theater.

Considerable expenditures for the device and setup can be saved byrequiring only a single supply device, so that no longer completesurgical hand pieces need to be exchanged for the differentapplications, but instead only the various complementary parts. Thisalso saves time during surgery.

The invention will now be described with reference to an exemplaryembodiment.

It is shown in:

FIG. 1 a simplified schematic diagram of the novel surgical device;

FIG. 2 a basic configuration of the surgical hand piece with the detailX;

FIG. 3 a first complementary part in form of a stabilizing handle forthe injection cannula;

FIG. 4 a second complementary part in form of a stabilizing handle witha stabilizing tube; and

FIG. 5 a third complementary part in form of a stabilizing handle with asuction tube and the details X and A-A.

As seen in FIG. 1, the surgical device includes a supply unit 1 and asurgical hand piece 2. The supply unit 1 includes a vacuum pump 3 with areceptacle container 4, a supply pump 5 with a supply container 6 for asterile separation fluid that can be formed into a jet, and a supplypump 7 with a supply container 8 for an anesthetic or another processfluid.

The vacuum pump 3 is connected via a vacuum line 9 with the surgicalhand piece 1. Conversely, the two supply pumps 5 and 7 each haverespective pressure lines 10 and 11, with both pressure lines 10, 11terminating at a switchable distribution valve 12. The distributionvalve 12 is provided to enable alternative use of the two supply pumps 5and 7, and is connected on the consumption side with the surgical handpiece 1 via a pressure supply line 13.

The surgical hand piece 1 includes, as also shown in greater detail inFIG. 2, a hand piece 14 with an interior injection line 15 and a suctionline 16 that surrounds the injection line 15. The injection line 15emerges from the suction line 16 on the proximal side of the hand piece14 and is connected with the pressure supply line 13 via a coupler 17,whereas the suction line 16 is connected to the vacuum line 9 with acoupler 18. A stationary injection cannula 19 that is connected with theinjection line 15 is located on the distal side of the hand piece 14.The free end of the injection cannula 19 is formed as a conically tippedinjection nozzle and preferably has a nozzle opening 20 formed as a slitand disposed on the conical surface. Because of this configuration ofthe nozzle opening 20 on the conical surface, the fluid jet exits in adirection different from the axis of the injection cannula 19. Thenozzle opening 20 is sized so that, for a selected pressure in thepressure supply line 13, a substantially flat fluid jet exits whichexerts a peeling separation effect on the tissue cells.

The length of the injection cannula 19 can be adapted to reach also thedeeper tissue regions.

FIG. 3 shows a first complementary part for stabilizing the injectioncannula 19 for injecting an anesthetic. Since the relatively long andthin injection cannula 19 is not dimensionally stable, but only arelatively shallow puncture depth is required for injecting ananesthetic, the complementary part in the depicted embodiment consistsof a stabilizing handle 21 that is placed onto the injection cannula 19and screwed into the hand piece 14. This arrangement increases theguided and supported length on the hand piece 14. For ergonomic reasons,the stabilizing handle 21 and the hand piece 14 have the same outsidedimensions and a complementary design.

FIG. 4 shows another complementary part which includes a stabilizinghandle 21′ and an attached stabilizing tube 22 that supports theinjection cannula 19 over its entire length. The free end of theinjection cannula 19 is open and has a suitable length, so that asufficiently long section of the nozzle opening 20 of the injectioncannula 19 protrudes from the stabilizing tube 22. The stabilizedinjection cannula 19 can be used to apply an anesthetic or anotherprocess fluid to deeper tissue layers.

Finally, FIG. 5 shows a complementary part with a stabilizing handle 21″and an attached suction tube 23. The suction tube 23 is dimensioned soas to encompass the injection cannula 19 and to form in conjunction withthe injection cannula 19 an interior annular suction channel. Severalsuction bores 24 distributed about the periphery of the suction tube 23terminate in the annular suction channel. An axial bore 25 with adiameter that conforms with clearance to the diameter of the injectioncamera 19, is arranged on the distal end of the suction tube 23.Moreover, the suction tube 23 has a suitable length so that asufficiently long section of the nozzle opening 20 of the injectioncannula 19 protrudes from the axial bore 25.

The novel surgical device for removing tissue cells can be useduniversally and replaces a large number of special tools.

For example, the surgical device for injecting an anesthetic can be usedin the same manner as is typical before tissue removal. For thisprocedure, if required, the first complementary part in form of thestabilizing handle 21 or the second complementary part in the form ofthe stabilizing handle 21′ with the stabilizing tube 22 is initiallyplaced onto the injection cannula 19 and connected with the hand piece14. The distribution valve 12 of the supply unit 1 is then switched to aposition where the supply pump 7, for example for the anesthetic, isconnected with the injection line 15 via the pressure supply line 13.When the injection cannula 19 has entered the corresponding tissue part,the supply pump 7 is activated and a pre-measured quantity of anestheticis injected.

The novel surgical device with the same configuration of the surgicalhand piece 2 can also be used for injecting a process fluid, forexample, for dissolving tissue cells in advance. The distribution valve12 is then switched to a position, where the pressure supply line 13 isconnected with a supply container containing a correspondingtissue-dissolving process fluid.

However, the novel surgical device is primarily used for removal ofexcess fatty tissue or of tissue cells that can reproduce. For thisapplication, the third complementary part in the form of the stabilizinghandle 21″ with the suction tube 23 is placed over the injection cannula19 and connected with the hand piece 14 of the surgical hand piece 1.The distribution valve 12 is switched to a position where the pressuresupply line 13 is connected with the supply pump 5 for the sterileseparation fluid 6.

After the suction tube 23 with the complementary injection cannula 19has been inserted in the corresponding tissue layer, the supply pump 5for the separation fluid and the vacuum pump 3 are turned on, wherebythe pumping capacity of the two pumps 3, 5 is matched. The separationfluid then exits the nozzle opening 20 of the injection cannula 19 as aflat jet that is directed away from the axial direction, and isdeflected in an intelligent manner into the gaps between the tissuecells. As a result, the tissue cells are not exposed to the separationforce, but are instead only urged apart and separated. The tissue cellspeeled away in this manner are simultaneously suctioned off togetherwith the consumed separation fluid by vacuum force and transportedthrough the suction bores 24, the inner annular suction channel and thesuction line 16 of the surgical hand piece 2 and through the vacuum line9 into the receptacle container 4. From there, the collected tissuecells are disposed of or sorted for further processing, as required.

LIST OF REFERENCE CHARACTERS

-   -   1 supply device    -   2 surgical hand piece    -   3 vacuum pump    -   4 receptacle container    -   5 supply pump    -   6 supply container for a sterile separation fluid    -   7 supply pump    -   8 supply container for an anesthetic or a process fluid    -   9 vacuum line    -   10 pressure line    -   11 pressure line    -   12 switchable distribution valve    -   13 pressure supply line    -   14 hand piece    -   15 injection line    -   10 suction line    -   17 coupler    -   18 coupler    -   19 injection cannula    -   20 nozzle    -   21 stabilizing handle    -   22 stabilizing tube    -   23 suction tube    -   24 suction bore    -   25 axial bore

1-5. (canceled)
 6. A surgical device for injecting a fluid and/or forremoving tissue cells from a biological structure, comprising (a) asupply device (1) including a fluid jet unit for injecting a separationfluid or a process fluid and/or including a suction device forsuctioning off separated or dissolved tissue cells and/or the separationfluid or the process fluid, and (b) a surgical hand piece (2) with aninner injection cannula (19) and an outer suction tube (23), both ofwhich form an annular suction channel in the region of the surgical handpiece (2), wherein the outer suction tube (23) is adapted to be placedon the injection cannula (19) and to be secured to the surgical handpiece (2), and wherein the injection cannula (19) includes a frontnozzle opening (20) and the suction tube (23) includes a plurality ofsuction bores (24) distributed along its periphery, and wherein thesurgical hand piece (2) is provided with a handle (14) and the suctiontube (23) is configured with a handle (21″) to form a complementarypart, wherein the outside dimensions of the handle (14) of the surgicalhand piece (2) are adapted to those dimensions of the handle (21″) ofthe suction tube (23), and wherein the handle (14) of the surgical handpiece (2) is configured to be connectable with the handle (21″) of thesuction tube (23) or optionally with another complimentary part thatalso includes an adapted handle (21, 21′).
 7. The surgical deviceaccording to claim 6, wherein another complementary part comprises astabilizing handle (21) for stabilizing the injection cannula (19). 8.The surgical device according to claim 6, wherein another complementarypart comprises a handle (21′) and an open stabilizing tube (22), whereinthe inner diameter of the stabilizing tube (22) matches with clearancethe outer diameter of the injection cannula (19) and the length of thestabilizing tube (22) is shorter than the length of the injectioncannula (19) by a sufficient amount, so that the tip of the injectioncannula (19) with the nozzle opening (20) protrudes by a sufficientlength.
 9. The surgical device according to claim 6, wherein the suctiontube (23) has a front axial bore (25) that matches with clearance thediameter of the injection cannula (19) and the length of the suctiontube (23) is shorter than the length of the injection cannula (19) by asufficient amount, so that the tip of the injection cannula (19) withthe nozzle opening (20) protrudes by a sufficient length.
 10. Thesurgical device according to claim 6, wherein for alternatively supplythe injection cannula (19) with different process fluids, the fluid jetunit of the supply device (1) is provided with one or more supply pumps(5, 7), and with a switchable directional control valve (12).